Exhibit 04 - Turb CT - WCJC.pdf

OHA - Drinking Water Program - Turbidity Monitoring Report Form County: Douglas

51 5 d M b D" E rth FI f U fit d 5 t ow an , em rane, latomaceous a I tra lon, or nl ere ,ys ems

System Name: USFS WOLF CREEK JOB CORPS 10 #: OR4101095 WTP-: WTP-A MonthNear:

12 AM 4AM 8AM NOON 4PM 8 PM

Highest Reading of

DAY 1

[NTUj [NTUj [NTUj [NTUj [NTUj [NTUj the Day

[NTU]

5 ..

Slow Sand/Membrane/DE Filtration/ynfiltered Monthly Summary (Answer Yes or No)

95% of daily turbidity readings s 1 NTU? 2 Yes / No CT's met everyday?

All CI2 residual at entry point ;:: 0.2 mg/l?

All daily turbidity readings s 5 NTU? Yes / No (see back) Yes / No Yes / No

Notes:

PRINTED NAME:

SIGNATURE: DATE:

PHONE #: ( ) CERT#:

" " Including continuous turbidity data, If applicable, for optimization recording Rurposes. Compliance values In columns 12 AM through "8 PM" may not correspond to continuous readings' maximum. 2 Filtered systems only.

OHA - Drinking Water Program - Surface Water Quality Data Form

I USFS WOLF CREEK JOB CORPS 10 #: OR4101095 WTP-: WTP-A Month/Year:

I

Minimum CI 2 Contact Peak Date I Residual at 1 sl Time

Actual Temp pH

Required CT Met? 3 Hourly .

Time CT CT Demand User ( C ) 3 ( T ) Flow

[ppm or mg/L] [minutes] CXT [0 C] Use Yes I No [GPM] tables

1 /

2/

3/

4/

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11 /

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21 /

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30/

31 / ~ If CI2 at entry pOint < 0.2 mg/l OR CT not met, notify DWP by end of next business day.

Download form at: www.public.health .oregon .gov/HealthyEnvironments/DrinkingWater/Monitoring/Documents/turb-alt-unfiltered.pdf